Outline

Voice restoration in patients after laryngectomy can be done by placing a shunt valve between the trachea and the esophagus. Unfortunately, voice prostheses become quickly colonized by microorganisms. Due to biofilm formation patients complain about leakage of food and liquid or increased air-flow resistance. Passing fluids into the trachea triggers coughing and may cause pulmonary infection. The aim of our study was to find out the lifespan and Voice restoration in patients after laryngectomy can be done by placing a shunt valve between the trachea and the esophagus. Unfortunately, voice prostheses become quickly colonized by microorganisms. Due to biofilm formation patients complain about leakage of food and liquid or increased air-flow resistance. Passing fluids into the trachea triggers coughing and may cause pulmonary infection. The aim of our study was lifespan Voice restoration in patients after laryngectomy can be done by placing a shunt valve between the trachea and the esophagus. Unfortunately, voice prostheses become quickly colonized by microorganisms. Due to biofilm formation patients complain about leakage of food and liquid or increased air-flow resistance. Passing fluids into the trachea triggers coughing and may cause pulmonary infection. The aim of our study was to find out the lifespan and the microbial colonization of dysfunctioning PROVOX voice prostheses in laryngectomized patients and to determine which hygienic risks can go out of by microogranisms colonized voice prostheses.

We analysed the life span and the microbial colonization of 25 PROVOX voice prostheses from 13 male laryngectomized patients between 5/2002 to 1/2004. The life span of prostheses varied from 1,5 months to a maximum of 14 months. The average life span was 4,7 months. The most prosthesis were removed when dysfunction of the prosthesis, such as leakage of fluids through the prosthesis (10) or an increase in phonation pressure (5), occurred. All replaced voice prostheses were cultured. The microbial cultures showed a predominant colonization with Candida spp. (11/25) and Staphylococcus aureus (8/25), followed by Klebsiella pneumoniae (6/25), Enterobacter cloacae (4/25), Enterococcus faecalis (4/25) and Escherichia coli (3/25). In two cases (two patients) multi-resistant bacteria were identified. For instance, some Staphylococcus aureus stems were resistant against Ampicillin, Tetracyline and Penicillin G. In the hospital, hygiene-measures must therefore be done to the prevent infection might going out from voice prosthesis carriers with multi-resistant bacteria.

These findings on microbial colonization and resistances against antibiotics could be used for the further development and modification of material features of voice prostheses to facilitate tracheoesophageal speech.